Finucane Melissa L, McMullen Carmit K
The Center for Health Research, Kaiser Permanente Hawaii, Honolulu, Hawaii (Dr Finucane)
The Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon (Dr McMullen)
Diabetes Educ. 2008 Sep-Oct;34(5):841-53. doi: 10.1177/0145721708323098.
The purpose of this study was to identify the cultural values, traditions, and perceptions of diabetes risk and self-care among Filipino Americans in Hawaii with type 2 diabetes that facilitate or impede engagement in diabetes self-management behaviors and education classes.
This qualitative study used 2 rounds of semistructured focus groups and interviews. Participants included 15 patients with type 2 diabetes recruited from a large health-maintenance organization in Hawaii and 7 health care and cultural experts recruited from the community. The taped and transcribed focus groups and interviews were coded thematically. Participants evaluated example materials for diabetes self-management education (DSME) with Filipino Americans.
Several aspects of Filipino American culture were identified as central to understanding the challenges of engaging in self-management behaviors and DSME: (1) undertaking self-management while prioritizing the family and maintaining social relationships, (2) modifying diet while upholding valued symbolic and social meanings of food, (3) participating in storytelling in the face of stigma associated with diabetes, and (4) reconciling spiritual and biomedical interpretations of disease causality and its management. Respondents also emphasized the role of several qualitative aspects of perceived risk (eg, dread, control) in moderating their behaviors. Participants suggested ways to make DSME culturally relevant.
Awareness of cultural values and qualitative aspects of perceived risk that influence Filipino Americans' engagement in diabetes self-care behaviors and classes may help to improve teaching methods, materials, and recruitment strategies.
本研究旨在确定夏威夷患有2型糖尿病的菲律宾裔美国人在糖尿病风险及自我护理方面的文化价值观、传统观念和认知，这些因素会促进或阻碍他们参与糖尿病自我管理行为及教育课程。
本定性研究采用两轮半结构化焦点小组讨论和访谈。参与者包括从夏威夷一家大型健康维护组织招募的15名2型糖尿病患者，以及从社区招募的7名医疗保健和文化专家。对录音并转录的焦点小组讨论和访谈进行主题编码。参与者对面向菲律宾裔美国人的糖尿病自我管理教育（DSME）示例材料进行了评估。
菲律宾裔美国文化的几个方面被确定为理解参与自我管理行为和DSME所面临挑战的核心：（1）在优先考虑家庭并维持社会关系的同时进行自我管理；（2）在坚持食物的重要象征意义和社会意义的同时调整饮食；（3）面对与糖尿病相关的污名化现象参与讲述经历；（4）调和对疾病因果关系及其管理的精神和生物医学解释。受访者还强调了感知风险的几个定性方面（如恐惧、控制）在调节其行为方面的作用。参与者提出了使DSME与文化相关的方法。
了解影响菲律宾裔美国人参与糖尿病自我护理行为和课程的文化价值观和感知风险的定性方面，可能有助于改进教学方法、材料和招募策略。
